Confirmed 2017 Open Enrollment Period QHP Selections: 2,638,473

But actually, he thought as he re-adjusted the Ministry of Plenty’s figures, it was not even forgery. It was merely the substitution of one piece of nonsense for another. Most of the material that you were dealing with had no connexion with anything in the real world, not even the kind of connexion that is contained in a direct lie. Statistics were just as much a fantasy in their original version as in their rectified version. A great deal of the time you were expected to make them up out of your head. For example, the Ministry of Plenty’s forecast had estimated the output of boots for the quarter at 145 million pairs. The actual output was given as sixty-two millions. Winston, however, in rewriting the forecast, marked the figure down to fifty-seven millions, so as to allow for the usual claim that the quota had been overfulfilled. In any case, sixty-two millions was no nearer the truth than fifty-seven millions, or than 145 millions. Very likely no boots had been produced at all. Likelier still, nobody knew how many had been produced, much less cared. All one knew was that every quarter astronomical numbers of boots were produced on paper, while perhaps half the population of Oceania went barefoot.

HOORAY! FACE-EATING LEOPARDS FOR EVERYONE!!

I don't write a whole lot about Medicare, since just about all U.S. citizens over 65 are covered by it and therefore don't enroll via the ACA exchanges anyway. However, it does come up on this site from time to time, and a good 55 million or so are enrolled in the program, so this little story might be of some relevance:

Last week, in my latest exclusive entry at healthinsurance.org, I crunched the numbers to see just how many people would likely lose their healthcare coverage if congressional Republicans, along with Republican President-elect Donald Trump, were to follow through with their explicit promise to repeal the Affordable Care Act (otherwise known as "Obamacare") early next year.

As I noted, the GOP is still incredibly vague about what exactly they'd replace the ACA with. No matter what they claim, it's only the "repeal" part which they've been clear about so far. All indications are that they plan on pushing the "repeal" part through almost immediately upon Trump taking office. Therefore, I focused specifically on what would happen if the ACA were repealed, in full, in early 2017 with immediate effect (as opposed to this weaselly 2-3 year delay business they've been bandying about which could potentially be even worse for the healthcare market as a whole in some ways).

Remember, there are four categories of people who would lose coverage:

Now that we're past Thanksgiving weekend and the big December 15th deadline (for January coverage) is coming up fast, OE4 enrollments should have started ramping up significantly, on the order of 250,000 per day or more nationally (around 190K via HC.gov).

As noted last week, so far, total enrollments have been pacing my overall projections almost perfectly...slightly ahead of my estimates for the first month, in fact. Assuming this continues, national QHP selections should have broken 4.1 million nationally sometime Monday night (12/05), with around 3.1 million of those coming via the federal exchange.

The Connecticut ACA exchange, AccessHealthCT, issued a press release today reminding Connecticut residents in general of the December 15th deadline for January 1st coverage. They also stressed, however, that while most current enrollees will be automatically renewed into either their existing policy, there are about 26,000 current enrollees who can't be auto-renewed because their carrier is leaving the exchange in 2017:

On December 1st, AHCT’s automatic renewal process began. The AHCT eligibility system will automatically enroll into 2017 coverage customers who have selected auto-renew and whose plans are still available. “But, there are 26,000 people who currently have coverage through AHCT who cannot auto-renew and must take action to renew their 2017 plans,” Wadleigh noted. Wadleigh reminds all customers “they should shop around and compare your options for 2017– that’s the purpose of the marketplace.”

NOTE: I've toned down the title a wee bit.

Read this (12/01/15):

Hey, remember the Risk Corridor Massacre? The one which is at least partly responsible (and in some cases, mostly responsible) for a dozen ACA-created Co-Ops (as well as at least one private insurance carrier in Wyoming) going out of business?

Well, there's two more rather interesting developments to the Risk Corridor mess.

Connect for Health Colorado just posted an official enrollment update:

DENVER — More than 37,000 Coloradans selected healthcare coverage for 2017 through the state health insurance Marketplace in November, a rate 23 percent ahead of signups one year ago, according to new data released today by Connect for Health Colorado®.

“The pace of sign-ups during the first month of this Open Enrollment has been very heartening,” said Connect for Health Colorado CEO Kevin Patterson. “We know that there is a lot of discussion now about the future direction of healthcare, but what remains constant and true is the importance of protecting the health and financial future of all Coloradans. I encourage everyone who needs health insurance to check to see if they qualify for financial assistance, review the available plans, and complete an enrollment before the last-minute rush.”

In the first month of the annual Open Enrollment period, Coloradans selected 37,948 medical and dental insurance plans. That compares to 30,777 such plan selections in November 2015.

 

Every month, the Kaiser Family Foundation conducts an extensive national survey about various issues, mostly having to do with healthcare for obvious reasons. Their November survey results are both facepalm-inducing and completely predictable at the same time.

Plenty of other outlets are doing full analysis of the survey, such as this one by Jonathan Cohn of the Huffington Post, and I'm swamped today, so I'll just focus on a couple of the charts.

Yesterday, over at the NY Times, Paul Krugman, writing about the supposedly imminent repeal of the Affordable Care Act, tried to answer the question "How many people just shot themselves in the face?"

After giving it several shots, a Twitter follower of mine suggested that he bring me in on the issue:

@paulkrugman You really need state-level data (hint: @charles_gaba). Trumpier states didn't expand Medicaid or encourage/support exchanges.

— (((MikeRose))) (@MikeRose2d) November 29, 2016

In my latest exclusive post over at healthinsurance.org, I did my best to come up with the answer. Check it out!

Last week I decided to once again take a crack at projecting not only the final number of 2017 Open Enrollment Period QHP enrollments nationally, but on a state-by-state basis. I started with a simple assumption of "2016 + 8.7%" (to match the national 13.8 milliion vs. 12.7 million projection made by both myself and the HHS Dept.), and then adjusted each state higher or lower based on various factors.

Now that CMS has broken out the first 4 weeks' worth of QHP selections via the federal exchange, in addition to the partial data I have on hand for some of the state-based exchanges, it's time to see where things stand compared to my personal projections. The only states where I know of an official projection are California and Connecticut, and even these have some wiggle room as they're more ranges than exact numbers.

With that in mind, here's what it looks like at the moment. Click the graph below for a high-resolution version. Things to note:

Some Guy, 11/28/16:

#ACASignups MEANWHILE, I'm pretty sure #ACA enrollments have hit 2.07M via HCgov, 2.69M nationally: https://t.co/D2fr0eBSEx #Obamacare #OE4 pic.twitter.com/BDHSVqVLuI

— Charles Gaba (@charles_gaba) November 28, 2016

HHS Secretary Sylvia Burwell, moments ago:

Minnesota's "first-come-first-serve" enrollment cap system caused a massive surge in early QHP selections...so much so that they kicked things off by signing people up at a pace twelve times faster than last year in the first few days.

That pace has slowed down considerably since then, but they're still well ahead of last year. In the first 17 days of OE3, MNsure was enrolling 404 people per day. In the first 27 days of OE4, MNsure has enrolled 29,783 people...or 1,103 per day:

With more than four weeks of open enrollment in the books, more than 57 percent of Minnesotans enrolling in a private health insurance plan through MNsure are qualifying for financial help available only through the state-based health insurance marketplace. The average tax credit amount going to MNsure customers will be more than three times higher in 2017 than it was in 2016.

As I understand it, the trend in the individual market has been moving away from wide-network PPOs and towards narrower-network HMOs for some time now...and while the ACA has certainly accelerated this trend, it had already started before the ACA came around.

Anyway, as I've noted before, my own family was among those who received the Scary Cancellation Notices® back in October 2013 letting us know that our pre-ACA Blue Cross Blue Shield of Michigan policy was being terminated for not complying with full ACA requirements (I think it was mostly the lack of mental health coverage, but there might've been other stuff as well).

We managed to work our way through HealthCare.Gov (this was after the worst HC.gov technical problems had been resolved, but while the system was still pretty buggy) and ended up enrolling in the closest equivalent ACA-compliant policy: A BCBSMI Gold PPO plan.

Last week I estimated that the Colorado exchange had around 26.4K QHP selections in the first 22 days of OE4 based on some fuzzy extrapolation.

Today, the Connect for Health Colorado Finance & Operations Committee had a meeting with the following slideshow...showing that they're doing even better than that: 29,045 QHP selections in those same 22 days.

However, there's also another important tidbit here (last slide below): While the average unsubsidized premium rates for Colorado exchange enrollees officially went up 16.9%, the final premium cost to the enrollees is actually dropping by 1.9% (from $214/month to $210/month):

In Colorado, the typical consumer who has already used Affordable Care Act subsidies to buy exchange plan coverage for 2017 is on track to spend less on premiums next year.

The good news: Neither Ben "the Egyptian Pyramids stored grain" Carson nor Bobby "monitoring volcanoes is a wacky idea!" Jindal will become Donald Trump's Health & Human Services Secretary.

The bad news: Instead, it'll be Georgia Representative Tom Price. None too fond of the Affordable Care Act is he, as you might imagine. Also none too fond of Medicare either. Or of Medicaid, for that matter. Or, while I'm at it, the Children's Health Insurance Program (CHIP).

If President-elect Donald J. Trump wanted a cabinet secretary who could help him dismantle and replace President Obama’s health care law, he could not have found anyone more prepared than Representative Tom Price, who has been studying how to accomplish that goal for more than six years.

Mr. Price, an orthopedic surgeon who represents many of the northern suburbs of Atlanta, speaks with the self-assurance of a doctor about to perform another joint-replacement procedure. He knows the task and will proceed with brisk efficiency.

Mr. Trump has selected Mr. Price, a six-term Republican congressman, to be secretary of health and human services, according to a transition team official.

Just to give you a taste of what Rep. Price has in mind, Edwin Park of the Center on Budget and Policy Priorities has written up a summary of how Medicaid would fare if he gets what he wants:

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